Amalgam substitutes: a critical analysis

PURPOSE: Quality standards for restorations recently have been defined in Switzerland. Amalgam substitutes must meet restoration Grade 2 requirements (i.e., pulp and dental hard substance must be preserved, and both form and function of the tooth have to be reconstituted). The pertinent operative technique has to be simple and amalgam-like. A minimum service life of 8 years is required. This in vitro study investigated the clinical potential of several amalgam substitutes, taking into account the operative requirements, the defined restorative guidelines, and the required service life. MATERIALS AND METHODS: Potential amalgam substitutes evaluated in this study included compomers (Compoglass, Dyract, Dyract AP, Elan, F 2000) and resin-based composites (Alert, Ariston, Definite, Nulite, Solitaire, Surefil). The composites Adaptic and Tetric Cream, using a simplified placement technique, were tested as negative and positive controls, respectively. Marginal adaptation and wear properties were measured in vitro in mixed Class II cavities. Relative radiopacity was measured in terms of millimeters of equivalent aluminum. RESULTS: All compomers showed a radiopacity of 2.5 mm or more aluminum. Only Dyract AP and Elan were more wear resistant than amalgam. After stressing, the percentage of continuous margin was at best 31% overall and 17% in dentin only. Among resin-based composites, the minimum requirements of radiopacity were fulfilled only by Alert, Surefil, and Tetric. Only Definite, Surefil, Solitaire, and Tetric exhibited wear resistance greater than amalgam. After stressing, the best marginal qualities were 41% continuous margin overall, and 8% in dentin only.     

Effect of resin-based material combination on the compressive and the flexural strength

The mechanical properties, elasticity and compressive strength, of restorative materials play a crucial role during mastication for clinical performance of materials in particular stress bearing areas at posterior regions. This in vitro study was objected to evaluate the changes in the compressive and flexural strength of tooth-coloured resin-based dental restorations placed on flowable composites. Specimens in the control group were produced in cylindrical form for testing compressive strength and in quadrangular prism form for flexural strength test. Tetric Ceram, Charisma, Surefil, Admira and two compomers; Dyract AP and Compoglass F in test group specimens were fabricated by placing the control materials on different flowables. The material combinations were as follows: Tetric Ceram/Tetric Flow Charisma/Flowline, Surefil/Dyract Flow, Admira/Admira Flow, Dyract AP/Dyract Flow, Compoglass F/Compoglass Flow. Compressive strength values were measured at the Instron Testing Machine with a cross-head speed of 10 mm min(-1) while flexural strength were determined in three-point bending with a cross-head speed of 1 mm min(-1). One-way anova and Tukey's multiple comparison tests were performed for the statistical analysis. The flexural strength values of Tetric Ceram/Tetric Flow (135.9 +/- 3.2), Charisma/Flowline (120.4 +/- 5.6) and Compoglass F/Compoglass Flow (108.2 +/- 5.2) combinations were statistically greater than Tetric Ceram (110.8 +/- 10.5), Charisma (95.3 +/- 5.3) and Compoglass F (86.9 +/- 4.9). The results of the present study support the idea that the placement of flowable composite as a liner under the resin-based composite restoratives increase the flexural strength.     

Microleakage of posterior packable resin composites with and without flowable liners

The use of flowable composites as liners in Class II packable composites has been suggested by some manufacturers. However, the contributions of this technique are unproven. This study evaluated marginal microleakage in Class II packable composite restorations with and without the use of a flowable composite liner. A conventional microhybrid composite was used as a control. Microleakage at occlusal and gingival margins of Class II cavities was evaluated using 45Ca and autoradiographs. Fifty non-carious, restoration-free human molar teeth were used. Separate mesio-occlusal and disto-occlusal Class II cavity preparations were made in each tooth. Gingival margins of all cavities were placed 1 mm apical to the cementoenamel junction (CEJ). Four Packable composites (Alert, Surefil, Pyramid and Solitaire) and one conventional microhybrid composite (Renew) with their respective manufacturer's bonding agents were used to restore the cavities. One side of each tooth was restored with composite alone, while the other side was restored with the composite lined with that manufacturer's flowable liner. The restored teeth were thermally stressed and 45Ca was used to evaluate microleakage. Two independent evaluators scored leakage based on the autoradiographs. The results showed flowable composites helped reduce microleakage at gingival margins of Class II restorations (p < 0.05). Gingival margins had higher microleakage than occlusal margins (p < 0.05). Without flowable liners, three packable composites (Alert, Pyramid and Surefil) showed higher leakage (p < 0.05) than the microhybrid control. Only Solitaire packable composite without liner showed no significant difference in microleakage to the control (p > 0.05). Although the flowable liners help reduce microleakage, Alert and Pyramid packable composites with liners still showed higher leakage than the control (p < 0.05). Surefil and Solitaire packable composites with flowable liners showed no significant difference in microleakage (p > 0.05) to the control.     

Sliding wear of 19 commercially available composites and compomers.

OBJECTIVES: The aim of this study was to determine the influence of particle size, particle material and morphology on the sliding wear of 19 light curing, commercially available composites (Durafill VS, Metafil CX, Heliomolar RO, Solitaire, Arabesk, Artglass, Charisma F, Pertac II, Charisma, Degufill Ultra, TPH Spectrum, Z100, Tetric classic, Pertac Hybrid, Estilux Hybrid, Dyract AP, Compoglass F, Compoglass and Hytac). METHODS: The materials were applied to an aluminum sample holder (7.5 mm diameter, 2 mm depth) in one layer and polymerized in a Dentacolor XS light curing unit for 180 s. The surface was ground flat (#1000) to remove any matrix rich surface layer. Then samples were stored in Ringer's solution for 24 h at 37 degrees C. Occlusal contact wear was simulated in a sliding wear tester (Munich Artificial Mouth). Eight specimens of each material were tested in a pin-on-block design with oscillating sliding of a Degussit antagonist (5 mm diameter) at a vertical load of 50 N. The horizontal excursion of the antagonist was 8 mm. Wear was quantified by a replica technique every 6000, 10,000, 30,000 and 50,000 cycles using a 3D-laser scanner. The materials were compared by their mean wear after 50,000 cycles. Comparisons of different composites and compomers were performed using analysis of variance and t-tests including the Bonferroni correction. RESULTS: The microfiller composites (Durafill VS, Metafil CX, Heliomolar RO) revealed the lowest, and the compomers (Dyract AP, Compoglass F, Compoglass and Hytac) showed the highest contact wear (p < 0.05). The wear of the hybrid composite (Estilux Hybrid) and the micro hybrid composites (Solitaire, Arabesk, Artglass, Charisma F, Pertac II, Charisma, Degufill Ultra, TPH Spectrum, Z100, Tetric classic, Pertac Hybrid) was higher than that of the microfiller composites (p < 0.05). The results showed additional significant differences within the three groups of composites. The coefficient of determination between loss of height and maximum particle size was r2 = 0.41. SIGNIFICANCE: Both particle size and morphology have a high influence on the wear properties concerning the two-body wear in the occlusal contact area.     

Polymerization contraction stress in light-cured packable composite resins.

OBJECTIVE: Determination of the polymerization contraction stress of packable composites (ALERT, Surefil, Solitaire, Solitaire 2) and a packable ORMOCER material (Definite) in comparison with a conventional hybrid composite (Tetric Ceram). METHODS: Contraction force generated by the test materials (10 replications each) was measured by polymerizing the composites filled in a plastic tray between two aluminum attachments mounted in a Stress-Strain-Analyzer testing machine (specimen size: 4x4x2 mm, C-factor=0.33). Contraction force was recorded for 300s under a standard exposure condition (40s, 800mW/cm(2)). Maximum contraction stress (MPa), force rate (N/s), relative force rate (%/s) of each material were statistically analyzed by ANOVA (alpha=0.05) and post-hoc Tukey's test. RESULTS: Maximum contraction stresses of the packable materials were 4.60 +/- 0.32MPa (ALERT), 4.16 +/- 0.18MPa (Definite), 3.36 +/- 0.08MPa (Solitaire 2), 3.33 +/- 0.23MPa (Solitaire) and 3.13 +/- 0.18MPa (Surefil), which were significantly higher than that of Tetric Ceram (2.51 +/- 0.14MPa). Tetric Ceram exhibited the significantly lowest force rate. Force/time curves were S-shaped. Solitaire especially showed a longer pre-gelation phase before contraction force was recorded. SIGNIFICANCE: High contraction stress and rapid contraction force development can lead to failure of bond to tooth structure. This study suggested that, packable composite resins are less capable of reducing the contraction stress during the early setting stage, thus not superior in maintaining the bond with cavity walls to conventional hybrid composite Tetric Ceram.     

Compomers as Class II restorations in primary molars

A variety of alternatives to amalgam are now available for use in class II restorations in primary teeth, including glass ionomer, composites, and intermediate materials such as compomer and resin modified glass ionomers (RMGI). The purpose of the present study was to evaluate the clinical performance of two compomers, Hytac and Dyract, and to compare these results to those reported for other intracoronal restorative materials. Evaluation after 24 months shows Hytac and Dyract to have performed well and comparably as class II restorations in primary teeth. The low failure rate, even in a population with a high caries increment, suggests that compomers are a suitable alternative to amalgam or other, tooth-colored materials when used as class II restorations in primary teeth.     

Selected mechanical properties of fluoride-releasing restorative materials

Mechanical properties, diametral tensile strength (DTS) and flexural strength (FS) of six fluoride releasing materials were measured and compared. The samples were prepared and tested according to ISO specifications. The materials included a glass ionomer (Fuji IX), a resin-modified glass ionomer (Photac-Fil), two compomers (F 2000; Dyract AP) and two composites (Solitaire; Tetric Ceram). The tests were performed after the materials were stored in distilled water (DTS) and phosphate buffered saline solution (FS) at 37 degrees C for 24 hours and one week. Fluoride-releasing composite resin had the highest flexural and diametral tensile strengths and were statistically stronger than compomers, followed by resin-modified glass ionomer and conventional glass ionomer. However, a notable exception to this general trend was Solitaire, a fluoride-releasing composite resin.     

The volumetric fraction of inorganic particles and the flexural strength of composites for posterior teeth

OBJECTIVE: To evaluate the content of inorganic particles and the flexural strength of new condensable composites for posterior teeth in comparison to hybrid conventional composites. METHOD: The determination of the content of inorganic particles was performed by mass weighing of a polymerized composite before and after the elimination of the organic phase. The volumetric particle content was determined by a practical method based on Archimedes' principle, which calculates the volume of the composite and their particles by differential mass measured in the air and in water. The flexural strength of three points was evaluated according to the norm ISO 4049:1988. RESULTS: The results showed the following filler content: Alert, 67.26%; Z-100, 65.27%; Filtek P 60, 62.34%; Ariston pHc, 64.07%; Tetric Ceram, 57.22%; Definite, 54.42%; Solitaire, 47.76%. In the flexural strength test, the materials presented the following decreasing order of resistance: Filtek P 60 (170.02 MPa)>Z-100 (151.34 MPa)>Tetric Ceram (126.14 MPa)=Alert (124.89 MPa)>Ariston pHc (102.00 MPa)=Definite (93.63 MPa)>Solitaire (56.71 MPa). CONCLUSION: New condensable composites for posterior teeth present a concentration of inorganic particles similar to those of hybrid composites but do not necessarily present higher flexural strength.     

Mechanical properties and wear behavior of light-cured packable composite resins.

OBJECTIVES: Determination of flexural strength, flexural modulus, fracture toughness and wear resistance of three packable composites (Solitaire, Surefil, ALERT) and a packable ormocer (Definite) in comparison with an advanced hybrid composite (Tetric Ceram) and an ion-releasing composite (Ariston pHc). METHODS: Flexural strength, flexural modulus and fracture toughness of each material were determined in three-point bending (each test n = 10). Single-edge notched-bend specimens were used to evaluate the fracture toughness (K1C). Wear of the materials (n = 8) was determined in a pin-on-block-design with a spherical Degusit antagonist at 50 N vertical load and quantified by a replica technique using a 3D-laser scanner. Replicas were made after 6000, 10,000, 30,000 and 50,000 load cycles. The mean wear rate (MWR (micron 3 cycle-1)) was obtained by a linear regression analysis in the steady-state of the time-wear-curve. All results were statistically analyzed with ANOVA and post hoc Tukey HSD tests (p < 0.05). RESULTS: ALERT exhibited the highest flexural modulus (12.5 +/- 2.1 GPa) and K1C (2.3 +/- 0.2 MN m-3/2), but the lowest wear resistance (8275 micron 3 cycle-1). Solitaire presented the highest wear resistance (1591 micron 3 cycle-1), but significantly lower flexural strength (81.6 +/- 10.0 MPa), flexural modulus (4.4 +/- 0.3 GPa), and K1C (1.4 +/- 0.2 MN m-3/2) than all other materials. Surefil revealed a significantly higher flexural modulus (9.3 +/- 0.9 GPa) and wear resistance (3028 micron 3 cycle-1) than Tetric Ceram (6.8 +/- 0.5 GPa; 5417 micron 3 cycle-1) and Ariston pHc (7.3 +/- 0.8 GPa; 7194 micron 3 cycle-1). SIGNIFICANCE: The tested packable composite resins differed significantly in their mechanical properties. This study suggested that fracture and wear behavior of the composite resins are highly influenced by the filler system. Overall, Surefil demonstrated good fracture mechanics parameters and a low wear rate.     

In vitro investigation of the performance of different restorative materials under cast circumferential clasps for removable dental prostheses

Objectives

The objective of this in vitro study was to investigate the behavior of different composite restorative materials under the load of cast circumferential clasps for removable dental prostheses (RDPs).

Methods

In 60 human molars, standardized mesial–occlusal–distal cavities were prepared. The cavities were restored with the following materials: Definite, Tetric Ceram, SureFil, Heliomolar RO, Ariston pHc, and Oralloy, and provided with a rest seat. The rest seats were subjected to 5,000 cycles of thermal cycling and 1,200,000 masticatory cycles in a mastication simulator via cobalt–chromium circumferential clasps cast to standardized frameworks in a laboratory model designed to simulate the biomechanics of a free-end denture base. Fracture analysis of the restorations was performed by light microscopy. Before and after loading, material wear was measured with a 3D-laser scanner, and an analysis of the marginal quality was performed in an SEM at ×200 applying the replica technique.

Results

No significant differences in the fracture behavior among the composite materials were found; the amalgam control group showed a significantly higher fracture resistance. Regarding the wear of the materials, the composites Definite and SureFil exhibited a behavior similar to that of amalgam. The other composites demonstrated higher wear rates. The initial marginal quality was significantly worse for Ariston pHc. The marginal adaptation decreased significantly after thermal and mechanical loading for Definite and Ariston pHc.

Conclusions

In terms of the investigated aspects of mechanical performance, the tested composites seemed to be inferior to amalgam. Further clinical studies are needed to evaluate the ability of composite restorations to provide support for RDP clasps.

Clinical relevance

The use of composites as direct restoration materials should be avoided in teeth, which serve as abutments for clasp-retained RDPs.     

Resin-based composites and compomers in primary molars

Resin-based composite resins and polyacid-modified resin-based composites (compomers) have become popular for the restoration of primary anterior and posterior teeth. In some European countries, resin-based composites or glass-ionomers are the materials of choice for primary teeth because of the controversy over dental amalgam and its alleged adverse health effects resulting from the release of mercury, although a clear correlation between amalgam restorations and health has not been determined. Another reason for the worldwide increased use of resin-based composites and glass-ionomers in pediatric dentistry could be attributed to the growing demand from parents to provide esthetic restorations to their children. More conservative preparations can be performed maintaining more tooth structure because of the adhesive properties of the composites and compomers. The most conservative treatment planning and meticulous care in the placement of the resin-based composites and compomers would produce long-term satisfactory results. These restorations should be placed in patients with low-to-moderate caries risk, and after placement the restorations should be monitored carefully to avoid complications mainly produced by recurrent caries and wear.     

The suitability of packable resin-based composites for posterior restorations

BACKGROUND: Packable composites, promoted for the restoration of stress-bearing posterior teeth, have captured clinicians' interest. METHODS: The authors tested three packable composites (Alert, Jeneric/Pentron; Solitaire, Heraeus Kulzer, Wehrheim, Germany; SureFil, Dentsply De Trey, Konstanz, Germany); a new packable organically modified ceramic, or ormocer (Definite, Degussa AG, Hanau, Germany); a hybrid composite (Tetric Ceram, Ivoclar Vivadent, Schaan, Liechtenstein) and an ion-releasing composite (Ariston pHc, Ivoclar Vivadent, Schaan, Liechtenstein). They determined modulus of elasticity according to EN 24049:1993 of the European Committee for Standardization. They measured Vickers hardness using a 200-gram load for 40 seconds. To determine the materials' depth of cure, they used both a scraping method (International Standards Organization standard CD 4049:1997) and a hardness profiling method. RESULTS: The authors calculated means and standard deviations from 10 replications of each test and used one-way analysis of variance and post hoc Tukey tests (alpha = .05). The materials had significant differences (P < .001) in all characteristics. Solitaire had the significantly lowest elastic modulus and microhardness; Alert had the highest values for these characteristics. Ariston pHc exhibited the significantly lowest depth of cure. There was a significant correlation between the two methods of measuring depth of cure (r2 = 0.9945; P = .021). CONCLUSIONS: The material group of packable composites is rather inhomogeneous in terms of mechanical and physical data. Our data suggest that bulk curing of packable composites in deep cavities still is not recommendable. CLINICAL IMPLICATIONS: The clinician needs to select packable composites carefully, as it seems that not all of these materials quality for stress-loaded posterior restorations.     

Shear peel bond strength of compomers veneered to amalgam

STATEMENT OF PROBLEM: The practice of veneering compomers to amalgam restorations has not been studied. PURPOSE: This in vitro study was designed to assess the shear peel bond strength and fracture pattern of 3 currently available compomers veneered to amalgam. MATERIAL AND METHODS: Sixty cylindrical preparations were filled with amalgam. Half (30) had no surface treatment, whereas the other half were air abraded. In both groups, 10 specimens each were veneered with Dyract AP, Hytac, and F2000 according to the manufacturers' instructions. All samples were kept at 37 degrees C in 100% relative humidity for 48 hours. SPBS was assessed with a universal testing machine and fracture patterns with a stereomicroscope. The results were analyzed with 2-way ANOVA and Tukey's multiple comparison test. RESULTS: Dyract AP veneered to air-abraded amalgam had the highest SPBS (5.78 +/- 1.30 MPa); F2000 veneered to non-air-abraded amalgam had the lowest (2.99 +/- 1.4 MPa). Sandblasting significantly influenced SPBS in the case of Hytac (P<.02) and F2000 (P<.01). Within the non-air-abraded group, Dyract AP had significantly higher SPBS than Hytac (P<.03) and F2000 (P<.015). F2000 air-abraded specimens exhibited adhesive bond failure only, whereas all other groups showed both adhesive and combined bond failures. CONCLUSION: Of the 3 compomers tested for veneering to amalgam, Dyract AP showed the highest SPBS. Air-abrading the amalgam surface was found to improve the SPBS of Dyract AP, though not significantly. Low SPBS and poor adhesion indicated that F2000 is unsuitable for veneering amalgam.     

Polymerization shrinkage and depth of cure of packable composites.

OBJECTIVE: This investigation evaluated polymerization shrinkage and depth of cure of five packable composites. METHOD AND MATERIALS: Five materials were used for the investigation: Alert, Surefil, Solitaire, P60, and Prodigy Condensable. Groups of 10 specimens of each material were made measuring either 2 or 5 mm in thickness, mounted in a testing jig, and polymerized using a dental curing light. Linear shrinkage was recorded and converted to a volumetric value. To evaluate depth of cure, ten specimens of each material were fabricated in both 2- and 5-mm thicknesses, and a Knoop hardness number was recorded on the top and bottom surfaces 5 minutes after light curing. A one-way analysis of variance statistical test was used to determine if there was a significant difference among materials. A Tukey multiple comparison test was then used to determine where significant differences existed. RESULTS: The volumetric shrinkage for the 2-mm-thick specimens from highest shrinkage to lowest were: Solitaire (3.3%), Prodigy Condensable (1.8%), Surefil (1.4%), P60 (1.2%), and Alert (0.2%). The 5-mm-thick specimens were ranked as follows: Solitaire (2.1%), Prodigy Condensable (1.0%), P60 (0.9%), Surefil (0.8%), and Alert (0.3%). Hardness for the bottom surface of the 2-mm-thick specimens showed that P60 (48.5) and Alert (42.6) had the highest values. Solitaire (11.2) had a significantly lower value. Hardness for the bottom surface at 5-mm thickness showed Alert (16.5) and P60 (16.3) with higher values than Surefil (8.9). CONCLUSION: Solitaire had the most shrinkage and Alert the least at both 2- and 5-mm depths. Depth of cure was severely compromised for all materials at 5 mm.     

Measurement of clinical wear of two packable composites after 6 months in service

Original large-particle composites exhibited poor wear characteristics. With the packable composites, there has been a reintroduction of large particles. The clinical wear characteristics of such packable composites are relatively unknown. The purpose of this study was to compare wear between two types of packable composites: Alert (Jeneric Pentron) and Surefil (Dentsply Caulk). Each material was compared with and without a surface sealant. Fifty-two subjects were included. Subjects had to have two to four eligible teeth, be 21 years of age, in good health and in need of moderate to large class 2 restorations on molars, and/or a two-surface class 1 on molars. Wear was assessed, using the Moffa-Lugassy (ML) scale, by evaluating stone models made from polyvinyl siloxane (PVS) impressions taken at baseline and 6 months. Rating was done by four calibrated examiners using a forced consensus model. The use of a surface sealant with Alert significantly reduced the median wear rate at 6 months compared with that of the SureFil restorations.     

Wear and microhardness of different resin composite materials

This study determined the three-body abrasive wear resistance of two packable composites (P-60; Solitaire 2), an ion-releasing composite (Ariston AT), a hybrid composite (Tetric Ceram) and an ormocer (Admira). The study also looked at the correlation between wear resistance and hardness of the composites. Three-body wear testing was performed using an ACTA wear machine with 15 N contact force using millet seed as the third body. Wear depth (microm) was measured by profilometry after 200,000 cycles. The hardness test was performed using a digital microhardness tester (load: 500 g; dwell time: 15 seconds). The data were analyzed by using Kruskal Wallis (p < 0.05). There were statistically significant differences among the three body abrasive wear of the composites. The ranking from least to most were as follows: Filtek P-60 < Solitaire 2 < Ariston AT < Tetric Ceram < Admira. Filtek P-60 showed the highest microhardness value. No other significant differences in hardness were observed among the different resin composites (P-60 > AristonAT = Tetric Ceram = Solitaire 2 = Admira). The results of this study indicate that there are significant differences in the wear resistance of the resin composites. The correlation between hardness and wear was significant with a correlation coefficient of r:-0.91. A significant negative correlation exists between hardness and three-body wear of resin composites.     

The leakage of Class II cavities restored with packable resin-based composites

Recently, new resin-based composites, called "packable" or "condensable" resin composites, are being promoted as amalgam alternatives. The purpose of this study was to evaluate leakage in Class II cavities restored with the five packable resin-based composites. On 45 freshly extracted human molars, cavities were prepared following a standardized pattern in which the Class II cavity had a length of 3.0 mm, width of 2.0 mm, and depth of 1.5 mm occlusally. The proximal box had an axial depth of 1.5 mm and a buccolingual width of 4.0 mm. The cervical margin was located 1.0 mm below the cement enamel junction (CEJ). The teeth were randomly divided into five groups of 8 each. The cavity surface was conditioned with 36% phosphoric acid, rinsed, excess water removed, and a dental bonding adhesive (Prime&Bond NT) was used for all the cavities. The teeth were then restored according to the manufacturer's instructions: Group 1, Surefil; Group 2, Solitaire; Group 3, Alert; Group 4, Filtek P60; and Group 5, Prodigy Condensable. After the restorations were completed, the specimens were finished and polished with an aluminum-oxide-coated disc, thermocycled, stained, sectioned, and viewed under a stereomicroscope for leakage at occlusal/enamel and gingival/dentin margins. All test groups showed that leakage of gingival/dentin margins were greater when compared with leakage of occlusal/enamel margins. At the occlusal/enamel margins, there were no significant differences between the materials; however, at gingival/dentin margins, Filtek P60 and Prodigy Condensable demonstrated less leakage, while Solitaire demonstrated greater leakage.     

Color stability of fluoride-containing restorative materials

Six fluoride-releasing materials of shade A3 were tested: one glass ionomer (Fuji IX), one resin-modified glass ionomer (Photac-Fil), two compomers (F 2000 and Dyract AP) and two composites (Tetric Ceram and Solitaire). Disk-shaped specimens of each material were prepared according to manufacturer's instructions, polished and L*a*b* baseline measurements taken. Specimens were randomly divided into two groups and given four different treatments of UV light exposure and immersion in a staining solution. Chromo Meter color measurements were taken following each treatment. Two-way ANOVA and Duncan Multiple Range post-hoc tests were used to compare color changes as a function of the four treatment conditions and one-way ANOVA was used to compare materials for each treatment separately. The results showed significant difference in shade A3 between products. In general, the hydrophobic materials showed greater color stability and stain resistance than the hydrophilic materials. Tetric ceram had the best color stability and stain resistance, while Fuji IX had the least.     

Polymerization contraction stress in light-cured compomer restorative materials.

OBJECTIVE: The magnitude and kinetics of polymerization contraction stress build-up may be potential predictors of bond failure of adhesive restorations. The present study determined these properties of seven commercial compomers (Dyract, Dyract AP, F2000 Rasant, Hytac, Compoglass F, Luxat, Glasiosite). METHODS: Polymerization shrinkage was generated by 40 s light curing the test materials (800 mW/cm2). The contraction force induced was recorded for 300 s at room temperature (23-24 degrees C) by means of a Stress-Strain-Analyzer (C factor=0.33). Maximum contraction stress (MPa), coefficient of near linear fit of contraction force/time (gradient) and relative force rate (%/s) of each material were compared with that of two hybrid composites (Tetric Ceram, Prodigy). The statistical analysis was conducted by ANOVA (alpha=0.05) and post hoc Tukey's test. RESULTS: No statistically significant differences in the maximum stress between Glasiosite (2.27+/-0.06 MPa), Hytac (2.31+/-0.07 MPa) and Tetric Ceram (2.21+/-0.11 MPa), and between Compoglass F (2.60+/-0.18 MPa) and Prodigy (2.70+/-0.06 MPa) were found. The contraction stress of F2000 Rasant (3.41+/-0.09 MPa) and Luxat (3.33+/-0.08 MPa) were significantly highest, whilst Dyract exhibited the significantly lowest shrinkage stress (1.27+/-0.08 MPa) among the tested materials. SIGNIFICANCE: High contraction stress, early start of stress build-up and rapid contraction force development may lead to failure of bond to tooth structure. This study suggested that the contraction stress and kinetic behavior of compomers are generally similar to those of hybrid composites in a dry condition. Dyract might be superior in maintaining the bond with cavity walls compared to conventional hybrid composites in view of its low shrinkage stress.     

Clinical performance of a compomer and amalgam for the interproximal restoration of primary molars: a 24-month evaluation

OBJECTIVES: To evaluate the clinical performance of a compomer material (Dyract) in comparison with dental amalgam (Contour) for management of proximal caries in primary molars in young children. SETTING: General dental practice, and a dental hospital paediatric clinic. METHOD: This was a prospective study. A split mouth design was used with identical pairs of minimal Class II cavities, of matched tooth type in the same dental arch, usually diagnosed with the use of bitewing radiographs. Seventy-eight pairs of restorations were completed of which 60 pairs were available for evaluation after 24 months. RESULTS: Comparable retention rates were observed for both Dyract and amalgam. The retention rates were high for both materials, with only four amalgam and two Dyract restorations failing over 24 months. Significantly better marginal integrity (P < 0.05) was observed for Dyract compared with amalgam with no significant differences between the two materials for recurrent caries, wear or surface texture. CONCLUSIONS: Dyract seemed to be a suitable alternative to amalgam for proximal restorations in primary molars of young children for use in general dental practice.